Quantum Health - Front-Line Customer Service Team of the Year

Company: Quantum Health: Dublin, OH
Company Description: Quantum Health is the industry-leading consumer healthcare navigation and care coordination company that delivers an unparalleled consumer experience to its members, as well as validated claims savings and high satisfaction rates for its self-insured employer clients.
Nomination Category: Customer Service & Call Center Awards Team Categories
Nomination Sub Category: Front-Line Customer Service Team of the Year - Other Service Industries

Nomination Title: Quantum Health:

Healthcare is a high-stakes, unchosen journey. It is costly, confusing, overwhelming, and stressful. It’s a journey no one should experience alone. Quantum Health’s front-line customer service team, called Healthcare WarriorsTM, ensures its members never do.

Quantum Health’s empathy-driven Warriors are oriented into “Pods” that include patient service representatives, nurses, claims specialists, and other experts. Clinical expertise guides their interactions as they support members in real time, across the care continuum, from receiving a life-changing diagnosis to settling claims and completing healthcare paperwork.

Millions of people across the country are healthier and less stressed because of the Warriors. Meanwhile, Warriors drive remarkable financial, operational, and clinical outcomes:

Savings: Employer clients realize millions of dollars in annual cost savings, including an average:
5.7% claims cost reduction after year one
9.2% cumulative claims savings after three years
14.4% cumulative claims savings after five years

Engagement: Quantum Health’s proprietary Real-Time Intercept® model identifies and engages members early, delivering:
Household engagement of 84%
Household engagement byQuantum’sclosest competitor is 54%

Patient outcomes: Employer clients exceed the national average in the following areas:
16%higher utilization of preventive care
7%fewer hospital in-patient days
10%fewer hospital readmissions

Quantum Health’s navigation services have never been more important than during the pandemic — and never have the individual stories of impact created by the Quantum Health Warriors been more powerful. As COVID-19 continues to devastate the nation, Warriors lead members through their healthcare journeys using empathy-based skills, clinical expertise, life-changing technology, and the company’s deep provider relationships.

For example, when Sarah could not access insulin for her daughter because of a COVID insulin shortage, her Warrior got her the medication. When Joe lost work hours due to COVID, his Warrior negotiated the cost of his diabetes medication, so he did not have to choose between life-saving medication and food. When Bobby struggled to find cancer treatment because hospitals were overrun with COVID patients, his Warrior found a way.

Amid the pandemic, Quantum Health experienced a year of extraordinary growth, adding dozens of employer clients and increasing member growth by 18%. The company now serves more than 2 million members. To support these members, Quantum Health increased Pod team members by 17%, bringing its total headcount to 1,600 during a time when hiring has been a nationwide challenge.

Throughout the pandemic, the company continued (and continues) to provide essential COVID-specific support to its members — including early assessment and symptom evaluation, resources for viral and antibody testing, virtual care access mapping, mental health support, point solution utilization, and compiling trusted resources to help answer questions around vaccination options.

In 2021, Quantum Health conducted research to better understand how healthcare complexity affects benefits utilization, patient engagement, and compliance with clinical care plans. This research showed that consumers experience multiple challenges when accessing healthcare and that complexity has a compounding effect on well-being and work life.

Quantum Health’s unique approach to navigation relies on Warriors to intervene early in the member journey to prevent or minimize complexity. While some navigation providers engage members only after a claim is filed, Quantum Health’s proprietary Real-Time Intercept® (RTI) model allows Warriors to proactively engage members up to 120 days before a first claim is filed. That’s 60 days earlier than competitors.

The combination of Quantum Health’s powerful RTI engine, deep clinical expertise, provider relationships, and empathy-based Warriors differentiates the company from competitors that rely solely on apps and portals to deliver navigation.

Quantum Health delivers an omnichannel consumer healthcare journey that improves engagement and reduces healthcare costs, but at its core is the personalized support of Healthcare Warriors. The Quantum Health model has been shown to:

-Reduce costs by as much as $75,000 per person for high-claims cases, such as cancer.

-Connect members to specially trained nurses with expertise in obstetrics, labor and delivery, and neonatal care who ensure all recommended screenings are completed on time, guiding expectant mothers through potential complications, such as gestational diabetes and pre-eclampsia.

-Help members with diabetes stay current with optimal care measures, such as annual eye and foot exams, hemoglobin A1C screenings, and kidney function testing.

Client testimonials: Quantum Health’s empathy-based approach to healthcare navigation and care coordination significantly influences members’ lives: securing care they were told their insurance would not cover; allowing a daughter to make the most of her father’s final days; guiding a woman through depression after the loss of her husband; or supporting a family during their young child’s cancer treatment. In all cases, with skill and caring, Healthcare Warriors ease healthcare complexity, helping members achieve the best possible result — and ensuring they are not alone in their journey. The attached Quantum Health Customer Service Testimonials exemplify the impact of Quantum Health’s Healthcare Warriors.

Survey Press Release: It’s no secret that healthcare is complex, but a groundbreaking study by Quantum Health in 2021 revealed the impact of complexity on consumers’ physical health, mental well-being, and workplace productivity. In addition, this research exposed a healthcare benefits knowledge and confidence gap between employers and employees, illustrating the need for employers to understand the negative impact healthcare complexity has on the physical and mental well-being of employees, and on workplace productivity.https://quantum-health.com/articles/consumer-insights-research-impact/

Bobby Duran Video: There is a human story behind every Healthcare Warrior interaction. This video highlights one of those stories. By acting as a liaison between healthcare providers and the health plan, Healthcare Warriors eased the burden of this daughter as she cared for her father during his cancer journey. Support from Healthcare Warriors gave her the gift of time that was free of the stress that comes with administrative healthcare tasks. https://navigate.quantum-health.com/diana-duran